Respiratory care
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Five-Year Follow-Up and Outcomes of Noninvasive Ventilation in Subjects With Neuromuscular Diseases.
The purpose of this study was to investigate the 5-year outcomes of noninvasive ventilation (NIV) application in different neuromuscular disease (NMD) groups. ⋯ NIV was tolerated long-term without significant increases in daily application time for most subjects with NMD. However, in individuals with ALS, development of severe bulbar symptoms can risk maintaining NIV.
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The incidence of chronically ill subjects with prolonged mechanical ventilation (PMV) has significantly increased over the last decade because of improvements in acute critical care. The aim of this study was to describe the outcomes and care pathways of subjects receiving PMV through a tracheostomy tube in an intermediate-care facility. ⋯ Despite the chance of survival at 1 y and/or weaning from ventilation, the resources needed by subjects with PMV are high, as shown by the number of readmissions and long LOS in our unit and in other hospital units before transfer.
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High-flow nasal cannula (HFNC) oxygen therapy produces noise at a level such that patients often complain. However, the noise level has not been measured digitally. ⋯ The findings in this study show that the noise level of HFNC/Venturi could be reduced by attaching an intake filter. However, the noise level of HFNC/blender and HFNC/turbine decreased in comparison with HFNC/Venturi without an intake filter.
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Exercise intolerance is the most predominant symptom in patients with COPD. Nevertheless, it is unclear whether walking economy and gait variability are altered in these patients. Thus, our main objective was to compare the cost of transport and gait variability as a function of speed, including the self-selected walking speed, in subjects with COPD relative to healthy subjects. ⋯ Subjects with COPD choose their walking speed so as to keep the dyspnea sensation tolerable and to keep gait variability and cost of transport at an acceptable level. These outcomes suggest that interventions acting on dyspnea and gait pattern may increase patients' self-selected walking speed and improve their quality of life.
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Observational Study
Air Travel for Subjects Receiving Long-Term Oxygen Therapy.
Ambulatory oxygen (O2) is the recommended treatment for hypoxemia at rest or induced by exercise. Commercial aircraft often fly at altitudes of 30,000 feet; their cabins are pressurized to altitudes of 6,000-8,000 feet, with an equivalent FIO2 of 0.15. O2 supplementation, for those receiving baseline ambulatory O2, is paramount. ⋯ Air travel is challenging; however, those who did travel reported a mainly positive experience. Increasing available information on options for travel should help individuals.